. The Richmond and Louisville medical journal. urethra. Beforeuniting the edges of the fistule, Bozeman slit open the rightureter with the vesical mucous membrane about one centimetre,in order to insure the uninterrupted flow of urine into the blad-der. After nine sutures had been introduced, five to the rightand four to the left side of the urethra, and adjusted in themanner described, it was found how free from fault the unionof the edges (one centimetre in thickness) had been made. Theline of union was concave upwards; it did not, however, run inan even, but rather in an undulating plane. F
. The Richmond and Louisville medical journal. urethra. Beforeuniting the edges of the fistule, Bozeman slit open the rightureter with the vesical mucous membrane about one centimetre,in order to insure the uninterrupted flow of urine into the blad-der. After nine sutures had been introduced, five to the rightand four to the left side of the urethra, and adjusted in themanner described, it was found how free from fault the unionof the edges (one centimetre in thickness) had been made. Theline of union was concave upwards; it did not, however, run inan even, but rather in an undulating plane. Figure 6. In accordance with this circumstance Bozemanshaped the plate in sucha manner as to make itconform exactly with theundulating plane, thus se-curing in an admirablemanner a close and exactunion of the two raw sur-faces. Figure 6 shows the general form of the plate as viewed uponthe upper surface, and the relation of it to the catheter sup-posed to be lodged in the urethra. The line below indicates thecurvature upon the concave VESICOVAGINAL FISTULE. 29 A catheter was kept permanently in the bladder. After theoperation feeble pains occurred, lasting, however, but one patient was without fever, and remained dry until the fifthday, when a small quantity of urine escaped into the vagina. July 20, Bozeman proceeded to remove the wires, remarking,at the same time, that he would be satisfied if there was uniononly to the extent of five sutures. To our great surprise, how-ever, the fistule was found almost completely closed; only a smallopening remained between the seventh and eighth sutures onthe left side, through which a surgeons probe could be passedinto the bladder. Bozeman ascribed the partial failure to theprobable obstruction of the left ureter within the united edgesof the fistule. The patient retained the catheter five days longer,when she was allowed to hold the urine for one-half to three-quarters of an hour, and to discharge it spontaneously. Boze-
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